Restoring Lives of Forgotten People Update

The project began in 2015 with activities taking place initially across six Blocks – Pusa, Bithan, Samastipur, Warisnagar, Khanpur and Singhiya. During the course of the project, two additional blocks were included – Morwa and Kalyanpur.

The overall aim of RLFP was to improve the health outcomes and psychosocial and financial wellbeing of the people marginalised by leprosy and LF, to enable effective community mobilisation and create sustainable health responses to leprosy and LF.

We took an integrated and holistic approach tackling not just the health issues but looking at the prejudice and discrimination associated with leprosy and LF.

We implemented this by:

• running leprosy and LF awareness-raising activities
• facilitating hydrocelectomies
• providing custom-made protective footwear
• creating a network of self-support groups to promote appropriate health behaviour, identify and advocate for people’s rights
• training healthcare workers and doctors

By the end of the project in 2020, we had reached 121,217 people affected by leprosy and LF with timely treatment, care and support.

Our integrated care approach has shown a substantial improvement in the health outcomes for people affected by leprosy or LF. Community initiatives have also helped to reduce discrimination or prejudice encountered by people affected.

By the end of the project, our work with RLFP demonstrated impact across health and wellbeing outcomes. Some highlights include:

• Reports of leprosy-related ulcers reduced from 30% in 2018 to 17% in 2021. Women were half as likely to report having had ulcers than men.
• One in five people affected by LF reported having had an acute attack recently (a debilitating form of inflammation in the affected part of the body), compared to 65% in 2018.
• Reporting practicing daily self-care, a key to reducing the risk of disability, doubled since 2018 for both leprosy and LF, reaching well over 90% of the people affected
• About 91% of participants affected by leprosy and 83% of people affected by LF, reporting attending social events, whereas only about 65% did so in 2018
• Only 12% of participants affected by either leprosy or LF falling under the poverty line (i.e. USD 1.9 per day), compared to approximately 42% in 2018
• On average, people affected by leprosy reported spending 80 Rs a month on medicines related to leprosy, compared to 500 Rs in 2018.
• About 98% of non-affected community participants agreed that people affected by LF could marry and about 95% of non-affected community participants agreed that people affected by leprosy could marry, compared to 44% for LF and 21% for leprosy before the intervention

However, people affected by LF still reported feeling discriminated against by the wider society with 33% of participants affected by leprosy and 30% affected by LF reported feeling excluded from society. One explanation may be that beneficiaries met with discrimination in the wider society while widening their social networks.

The RLFP project resulted in improved daily self-care practice and a decrease in ulcers, it halved the possibility of disability amongst beneficiaries, improved income, and decreased health care expenditure. It also increased social participation amongst the local and wider community. We still need to work on advocacy platforms to continue to reduce prejudice and discrimination in the wider society.